Safety and efficacy update on first-generation drug-eluting stents.
Accumulating data on the safety and efficacy of first-generation drug-eluting stents (DES) show a favorable risk/benefit profile compared with bare-metal stents (BMS). A recently reported collaborative network meta-analysis including >18,000 patients in 38 randomized trials along with other recent meta-analyses indicate that the use of DES versus BMS is associated with a 50%-70% reduction in the need for repeat revascularization and no difference in the rates of overall stent thrombosis, overall mortality, cardiac mortality, or death or myocardial infarction over 4 years of follow-up. Furthermore, the most recent data from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR) indicate no difference in mortality between DES and BMS use. The collaborative network meta-analysis and other analyses suggest that late stent thrombosis is a distinct but infrequent phenomenon complicating the use of DES; the risk posed by late thrombosis appears to be offset by a reduced need for repeat revascularizations and thus, a reduced risk of adverse outcomes associated with such interventions.
Spaulding
Christian
C
Cardiology Department, Cochin Hospital, René Descartes University, Paris, France. christian.spaulding@cch.ap-hop-paris.fr
D054855:Drug-Eluting Stents; D006801:Humans; D015201:Meta-Analysis as Topic; D008670:Metals; D009026:Mortality; D016032:Randomized Controlled Trials as Topic; D015607:Stents
D008670:Metals